Arthritis Treatment: Treating Obesity As a Treatment for Osteoarthritis

Osteoarthritis (OA) is the most common type of arthritis affecting at least 30 million Americans.

It is a disease that affects hyaline cartilage, the tough tissue that covers the ends of long bones. Hyaline cartilage consists of a complicated mixture of proteins, glycogen, and collagen.

OA develops when the cartilage matrix breaks down and begins to fragment. Small fissures called "fibrillations" develop. Over time the fissures become more pronounced as generalized OA progresses.

Unlike localized areas of cartilage damage that can occur as a a result of trauma, e.g., an athletic injury, OA appears to be a more generalized process that involves metabolic dysfunction of cartilage matrix and chondrocytes leading to a condition referred to as joint failure.

Risk factors for OA include injury to the joint, genetics, lifestyle, and age. OA is primarily a condition that affects weight-bearing areas of the skeleton.

As a consequence, excessive weight exerts a negative effect on symptoms of OA. Every extra pound a person carries creates approximately five extra pounds of load that the weight-bearing joint sees. So excessive weight can not only lead to joint damage over time- picture the number of excessive load impacts with every step an obese person takes- but also aggravates any underlying already existing arthritis.

However, that's not all. Recent studies have indicated that adipose tissue- fat cells- manufacture and release inflammatory proteins called cytokines. Since these cytokines are produced by fat cells (adipose cells), they are called adipokines. This would probably explain why people who have OA in the hands, a non-weight-bearing area- tend to have inflammatory changes in the finger joints.

Obesity is reaching epidemic proportions in the United States. Airlines are starting to charge double for people who can't sit in one seat. Disney has had to modify their rides to accommodate the wider bottoms of their visitors. The impact on other organ systems and co-morbid conditions has been mentioned previously. These include diabetes, hypertension, cardiovascular disease, gout, etc. These also have a deleterious effect on OA.

So, the major point of this article is to stress that obesity is a double whammy for OA. There is the mechanical load that aggravates the disease. Plus, there is the secondary, and possibly more severe, problem of an obese person carrying around a load full of toxic inflammatory proteins in their fat that makes the disease worse.

As a result, weight loss should be considered an integral component of a good treatment program for patients with OA.